About our research
Amongst other things, we have evaluated the effects of a person-centred approach in health care. Apart from the reduction of costs, significant positive effects from a patient perspective have been reported, as the care is tailored to each individual person, and his or her resources are considered and included.
Approximately 100 national and international researchers from different fields of study join forces to work on different studies at GPCC. These studies mainly revolve around person-centred care, rehabilitation, and elderly care in patient groups with different conditions, as well as organisation of care, and issues related to the implementation of person-centred care.
At GPCC, scientists from almost every faculty at the University of Gothenburg engage in interdisciplinary research. Experiences/symptoms of disease and ill health serve as a point of departure, and thus, a part of our research revolves around increasing understanding of the correlations between symptoms and organ dysfunctions, for example in cardiac and gastrointestinal disease. We also study how care and treatment can be improved through a person-centered approach, meaning that the patient’s narrative serves as a foundation for an agreement between the patient and health care professionals, regarding examinations and treatment. We also study how person-centred care can increase efficiency in health care. Furthermore, we work with the implementation of our results within health care.
GPCCs research can be sorted into four different domains:
- Theoretical and practical development of person-centred care
- Evaluation and measurement of person-centred care
- Implementation, organisation, leadership and governance of person-centred care
- Learning and education in person-centred care
Our research projects
Ongoing research projects
Completed research projects
Phd projects and theses
Person-centred care has positive effects
GPCC has evaluated the effects of a person-centred approach in a number of studies in different health and care contexts, for example in orthopaedic and internal medicine, as well as across the whole care continuum, from hospital care and outpatient care to primary care, and beyond. Apart from the reduction of costs, significant positive effects from a patient perspective have been reported, as the care is tailored to each individual person, and his or her resources are considered and included.
GPCC researchers conduct interdisciplinary research in various health care settings involving various groups of professionals and patients.
Theoretical and practical development
GPCC's research takes its starting point in ethics rooted in philosophical literature on what it means to be human, a person [1,2]. A key part of applying this ethic (person-centredness) in practice is to establish partnerships between healthcare professionals and patients (and relatives when relevant). This partnership is initiated by inviting patients to tell their narrative, actively listening to that narrative, agreeing on a plan for the patient's care and documenting the plan - in ways that becomes useful to the patient.
The research that has been carried out so far at GPCC has primarily been focused on adults. Person-centred care for children is an area under development, in which it is central to use the child's perspective as the starting point. Tools and methods like, for example, pictorial support and principles for universal design can be very helpful in achieving this .
Our research includes studies examining how partnerships can be created and developed, but also problematizing on what partnerships can entail [4-9].
Conversations between patients and healthcare professionals are central to the partnership. When conducting person-centred conversations in health care settings, a fundamental difference has been shown between talking to and talking together with the patient . For a conversation to be person-centred, it is central to talk with the patient. This can, for example, entail the patient and health care professional together agreeing on the agenda at the beginning of the conversation, and that both participants contribute with their respective knowledge and experience.
Our research focusing on conversations between patients and health care professionals involves different patient groups, for example, adult patients with mental disorders , irritable bowel syndrome (IBS) , cancer , adult patients with different types of communication disorders [13-14], and children with cancer or congenital heart defects .
Effects of person-centred care for patients
A large number of intervention studies on person-centred care have been conducted. Mainly in hospital care and specialized outpatient care, but some studies have also been conducted in primary care. The studies have mainly been carried out with experimental and quasi-experimental design . Experimental studies require that participants are randomly divided into groups that receive either person-centred care or standard care. Quasi-experimental studies entail participants being treated based on which health care unit they visit, for example, one hospital ward can provide person-centred care while another ward provides standard care. These interventions focus either on person-centred care in relation to a specific health problem (for example incontinence, obesity, or pain), or on the patient's general health.
A study compiling 15 of GPCC's controlled intervention studies found that 9 of these reported statistically significant improvements in at least one of the studied outcomes . Positive effects reported from adult/elderly patients are, for example, an increased confidence in one's own ability to manage one's illness (self-efficacy), an improved experience of health, and an improved satisfaction with care. Studies have also shown improved symptom control, improved physical function/capacity, improved activities of daily living, and fewer deteriorations for people with chronic heart failure and chronic obstructive pulmonary disease.
In yet another publication, where the effect of a person-centred intervention aimed at young people with chronic pain was evaluated, an increased confidence in one's own ability to participate in everyday activities was noted .
GPCC's research also includes studies in which person-centred care has been carried out remotely, by telephone or via digital platforms. An increasing number of technical solutions to facilitate person-centred care remotely have been evaluated in recent years [19-21]. In a study where intervention via a digital platform in combination with telephone support was tested, patients report that person-centred care ensured they were given access to support for self-management according to their own needs . In another study where a digital app for self-management of high blood pressure was evaluated, results show that patients feel that they have taken on a more active role in their own care and that co-creation between patient and care staff was facilitated .
Effects of person-centred care for staff
There are also studies that have shown positive effects for health care staff from a person-centred approach, such as improved satisfaction with their work, reduced stress of conscience and an improved psychosocial work environment .
Use of resources
Health economics studies are important for understanding how society's common resources are used. Some studies have examined the effects of introducing person-centred care on the health system's resource use and costs. A couple of studies which observed the length of hospital stay showed that person-centred care led to shorter hospital stays [23,24], and that the shorter stay did not increase the risk of readmission or jeopardize the patient's health-related quality of life . Several studies have also shown that person-centred care can lead to cost savings or be cost-effective compared to standard care [25-28].
There are also studies that show that person-centred care leads to a more efficient use of resources in health care [29-31]. For example, in a study evaluating an intervention for patients for whom cancer surgery was planned, positive effects were seen on the patients' ability to search and use information, and patients knew who to turn to a greater extent, instead of for example visiting the emergency department .
Implementation of person-centred care
Studies that evaluate the implementation of person-centred care have been carried out in various settings, for example in hospital care [32-37], in psychiatric care , and in care of older people in out-of-hospital settings .
Key factors described for implementation of person-centred care are, for example, creating a common intention for change (sense of urgency) and that co-creation between care staff from different professions is facilitated . Strong leadership and strategies for overcoming existing methods for documentation have also been described as crucial . Several factors can affect implementation, such as differences in the understanding of what person-centred care includes and how it should be practiced, which can be linked to both local traditions in the workplace and different professions in the team .
The introduction of teaching methods and learning of person-centredness has also been investigated in higher education at universities. A study of university teachers' experience of developing an inter-professional course in person-centred care showed, for example, that there was an unfamiliarity with the pedagogy involved in the learning of person-centred care . Creating partnerships between the teachers involved and with students was seen as crucial.
Practice tools for person-centred care
Over the years GPCC researchers have developed and tested a variety of practice tools to support the learning, implementation and evaluation of person-centred care in various ways. Strategies for elicitation of patient narratives and co-creation of health and care, information materials, validated questionnaires, videos and digital platforms are some examples of such tools. You can read more about the types of tools that have been developed or are under development here.
 Ekman, I., Swedberg, K., Taft, C., Lindseth, A., Norberg, A., Brink, E., Carlsson, J., Dahlin-Ivanoff, S., Johansson, I-L., Kjellgren, K., Lidén, E., Öhlén, J., Olsson, L-E., Rosén, H., Rydmark, M., & Stibrant Sunnerhagen, M. (2011). Person-centered care - Ready for prime time. European Journal of Cardiovascular Nursing, 10(4), 248-251. doi:10.1016/j.ejcnurse.2011.06.008.
 Britten, N., Moore, L., Lydahl, D., Naldemirci, Ö., Elam, M., & Wolf, A. (2017). Elaboration of the Gothenburg model of person-centred care. Health Expectations, 20(3), 407-418. doi:10.1111/hex.12468
 Thunberg, G., Johnson, E., Bornman, J., Öhlén, J., & Nilsson, S. (2021). Being heard–Supporting person‐centred communication in paediatric care using augmentative and alternative communication as universal design: A position paper. Nursing Inquiry, e12426. doi:10.1111/nin.12426
 Wolf, A., Moore, L., Lydahl, D., Naldemirci, Ö., Elam, M., & Britten, N. (2017). The realities of partnership in person-centred care: a qualitative interview study with patients and professionals. BMJ Open, 7(7), e016491. doi:10.1136/bmjopen-2017-016491
 Naldemirci, Ö., Lydahl, D., Britten, N., Elam, M., Moore, L., & Wolf, A. (2018). Tenacious assumptions of person-centred care? Exploring tensions and variations in practice. Health, 22(1), 54-71. doi:10.1177/1363459316677627
 Naldemirci, Ö., Britten, N., Lloyd, H., & Wolf, A. (2020). The potential and pitfalls of narrative elicitation in person-centred care. Health Expectations, 23(1), 238-246. doi:10.1111/hex.12998
 Naldemirci, Ö., Britten, N., Lloyd, H., & Wolf, A. (2021). Epistemic injustices in clinical communication: the example of narrative elicitation in person‐centred care. Sociology of health & illness, 43(1), 186-200. doi:10.1111/1467-9566.13209
 Friberg, F., Wallengren, C., Håkanson, C., Carlsson, E., Smith, F., Pettersson, M., Kenne Sarenmalm, E., Sawatzky, R., & Öhlen, J. (2018). Exploration of dynamics in a complex person-centred intervention process based on health professionals' perspectives. BMC Health Service Research, 18(1), 441. doi:10.1186/s12913-018-3218-3
 Heckemann, B., Chaaya, M., Jakobsson Ung, E., Olsson, D. S., & Jakobsson, S. (2020). Finding the Person in Electronic Health Records. A Mixed-methods Analysis of Person-centered Content and Language. Health Communication, 37(4), 418-424. doi:10.1080/10410236.2020.1846275
 Pettersson, M. E., Öhlen, J., Friberg, F., Hyden, L. C., Wallengren, C., Sarenmalm, E. K., & Carlsson, E. (2018). Prepared for surgery - Communication in nurses' preoperative consultations with patients undergoing surgery for colorectal cancer after a person-centred intervention. Journal of Clinical Nursing, 27(13-14), 2904-2916. doi:10.1111/jocn.14312
 Cederberg, M., Fors, A., Ali, L., Goulding, A., & Mäkitalo, Å. (2022). The interactive work of narrative elicitation in person-centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders. Health expectations, online ahead of print. doi:10.1111/hex.13440
 Forsgren, E., & Björkman, I. (2021). Interactional practices in person-centred care: Conversation analysis of nurse-patient disagreement during self-management support. Health expectations, 24(3), 940-950. doi:10.1111/hex.13236
 Saldert, C., Forsgren, E., & Hartelius, L. (2016). Teaching medical students about communication in speech-language disorders: Effects of a lecture and a workshop. International Journal of Speech-Language Pathology, 18(6), 571-579. doi:10.3109/17549507.2016.1143975
 Forsgren, E., Hartelius, L., & Saldert, C. (2017). Improving medical students' knowledge and skill in communicating with people with acquired communication disorders. International Journal of Speech-Language Pathology, 19(6), 541-550. doi:10.1080/17549507.2016.1216602
 Wiljén, A., Chaplin, J.E., Crine, V., Jobe, W., Johnson, E., Karlsson, K., Lindroth, T., Schwarz, A., Stenmarker, M., Thunberg, G., Öhlén, J., & Nilsson, S. (2022). The Development of an mHealth Tool for Children With Long-term Illness to Enable Person-Centered Communication: User-Centered Design Approach. JMIR Pediatrics and Parenting, 5(1), e30364. doi:10.2196/30364.
 Gyllensten, H., Björkman, I., Jakobsson Ung, E., Ekman, I., & Jakobsson, S. (2020). A national research centre for the evaluation and implementation of person‐centred care: Content from the first interventional studies. Health Expectations, 23(5), 1362-1375. doi: 10.1111/hex.13120
 Britten, N., Ekman, I., Naldemirci, Ö., Javinger, M., Hedman, H., & Wolf, A. (2020). Learning from Gothenburg model of person centred healthcare. BMJ, 370, m2738. doi: 10.1136/bmj.m2738
 Fors, A., Wallbing, U., Alfvén, G., Kemani, M. K., Lundberg, M., Wigert, H., & Nilsson, S. (2020). Effects of a person-centred approach in a school setting for adolescents with chronic pain—The HOPE randomized controlled trial. European Journal of Pain, 24, 1598–1608. doi:10.1002/ejp.1614
 Barenfeld, E., Ali, L., Wallstrom, S., Fors, A., & Ekman, I. (2020). Becoming more of an insider: A grounded theory study on patients' experience of a person-centred e-health intervention. PLoS One, 15(11), e0241801. doi:10.1371/journal.pone.0241801
 Andersson, U., Bengtsson, U., Ranerup, A., Midlöv, P., & Kjellgren, K. (2021). Patients and Professionals as Partners in Hypertension Care: Qualitative Substudy of a Randomized Controlled Trial Using an Interactive Web-Based System Via Mobile Phone. Journal of medical Internet research, 23(6), e26143-e26143. doi:10.2196/26143
 Ali, L., Wallstrom, S., Ekman, I., Swedberg, K., & Fors, A. (2021). Effects of person-centred care via telephone on self-efficacy in patients with chronic obstructive pulmonary disease: Subgroup analysis of a randomized controlled trial. Nursing Open, 8(2), 927-935. doi:10.1002/nop2.701
 van Diepen, C., Fors, A., Ekman, I., & Hensing, G. (2020). Association between person-centred care and healthcare providers' job satisfaction and work-related health: a scoping review. Bmj Open, 10(12). doi:10.1136/bmjopen-2020-042658
 Ekman, I., Wolf, A., Olsson, L. E., Taft, C., Dudas, K., Schaufelberger, M., & Swedberg, K. (2012). Effects of person-centred care in patients with chronic heart failure: the PCC-HF study. European Heart Journal, 33(9), 1112-1119. doi:10.1093/eurheartj/ehr306
 Hansson, E., Ekman, I., Swedberg, K., Wolf, A., Dudas, K., Ehlers, L., & Olsson, L. E. (2016). Person-centred care for patients with chronic heart failure - a cost-utility analysis. European Journal of Cardiovascular Nursing, 15(4), 276-284. doi:10.1177/1474515114567035
 Gyllensten, H., Koinberg, I., Carlstrom, E., Olsson, L. E., & Hansson Olofsson, E. (2019). Economic evaluation of a person-centred care intervention in head and neck oncology: results from a randomized controlled trial. Support Care Cancer, 27(5), 1825-1834. doi:10.1007/s00520-018-4436-2
 Pirhonen, L., Bolin, K., Olofsson, E. H., Fors, A., Ekman, I., Swedberg, K., & Gyllensten, H. (2019). Person-Centred Care in Patients with Acute Coronary Syndrome: Cost-Effectiveness Analysis Alongside a Randomised Controlled Trial. PharmacoEconomics Open, 3(4), 495-504. doi:10.1007/s41669-019-0126-3
 Pirhonen, L., Gyllensten, H., Fors, A., & Bolin, K. (2020a). Modelling the cost-effectiveness of person-centred care for patients with acute coronary syndrome. European Journal of Health Economics, 21(9), 1317-1327. doi:10.1007/s10198-020-01230-8
 Pirhonen, L., Gyllensten, H., Olofsson, E. H., Fors, A., Ali, L., Ekman, I., & Bolin, K. (2020b). The cost-effectiveness of person-centred care provided to patients with chronic heart failure and/or chronic obstructive pulmonary disease. Health Policy Open, 1, 100005. doi:10.1016/j.hpopen.2020.100005
 Larsson, I., Bergman, S., Fridlund, B., & Arvidsson, B. (2012). Patients’ experiences of a nurse-led rheumatology clinic in Sweden: A qualitative study. Nursing & Health Sciences, 14(4), 501-7. doi: 10.1111/j.1442-2018.2012.00723.x.
 Larsson, I., Fridlund, B., Arvidsson, B., Teleman, A., & Bergman, S. (2014). Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. Journal of Advanced Nursing, 70(1), 164-75. doi:10.1111/jan.12183
 Öhlen, J., Sawatzky, R., Pettersson, M., Sarenmalm, E. K., Larsdotter, C., Smith, F., Wallengren, C., Friberg, F., Kodeda, K., & Carlsson, E. (2019). Preparedness for colorectal cancer surgery and recovery through a person-centred information and communication intervention - A quasi-experimental longitudinal design. PLoS One, 14(12). doi:10.1371/journal.pone.0225816
 Alharbi, T. S., Ekman, I., Olsson, L. E., Dudas, K., & Carlström, E. (2012). Organizational culture and the implementation of person centered care: results from a change process in Swedish hospital care. Health Policy, 108(2-3), 294-301. doi:10.1016/j.healthpol.2012.09.003
 Alharbi, T., Carlström, E., Ekman, I., & Olsson, L.-E. (2014). Implementation of Person Centered Care: Management Perspective. Journal of Hospital Administration, 3(3), 107-120. doi:10.5430/jha.v3n3p107
 Carlstrom, E., & Olsson, L. E. (2014). The association between subcultures and resistance to change - in a Swedish hospital clinic. Journal of Health Organization and Management, 28(4), 458-476. doi:10.1108/Jhom-09-2012-0184
 Friberg, F., Wallengren, C., Hakanson, C., Carlsson, E., Smith, F., Pettersson, M., Kenne Sarenmalm, E., Sawatzk, R., & Öhlen, J. (2018). Exploration of dynamics in a complex person-centred intervention process based on health professionals' perspectives. BMC Health Service Research, 18(1), 441. doi:10.1186/s12913-018-3218-3
 Erichsen Andersson, A., Frodin, M., Dellenborg, L., Wallin, L., Hok, J., Gillespie, B. M., & Wikstrom, E. (2018). Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study. BMC Health Services Research, 18(1), 2. doi:10.1186/s12913-017-2783-1
 Dellenborg, L., Wikstrom, E., & Erichsen, A. A. (2019). Factors that may promote the learning of person-centred care: an ethnographic study of an implementation programme for healthcare professionals in a medical emergency ward in Sweden. Advances in Health Sciences Education, 24(2), 353-381. doi:10.1007/s10459-018-09869-y
 Allerby, K., Goulding, A., Ali, L., & Waern, M. (2020). Striving for a more person-centered psychosis care: results of a hospital-based multi-professional educational intervention. BMC Psychiatry, 20(1), 523. doi:10.1186/s12888-020-02871-y
 Ebrahimi, Z., Patel, H., Wijk, H., Ekman, I., & Olaya-Contreras, P. (2021). A systematic review on implementation of person-centered care interventions for older people in out-of-hospital settings. Geriatric Nursing, 42(1), 213-224. doi:10.1016/j.gerinurse.2020.08.004
 Moore, L., Britten, N., Lydahl, D., Naldemirci, O., Elam, M., & Wolf, A. (2017). Barriers and facilitators to the implementation of person-centred care in different healthcare contexts. Scandinavian Journal of Caring Sciences, 31(4), 662-673. doi:10.1111/scs.12376
 Rosengren, K., Danielsson, L., Jansson, I., & Wallengren, C. (2018). Development of an Academic Course in Person-Centred Care for Students in Higher Education: Teachers' Perspectives. Education Research International. doi:10.1155/2018/9854169